Drugs & Aging最新文献

{"title":"Correction: Cardiovascular-Related Polypharmacy and Its Association with Liver and Kidney Function: A Cross-Sectional Study Using Primary Care Data.","authors":"Caroline Trin, Harvey Jia Wei Koh, Zhomart Orman, Dianna J Magliano, Ella Zomer, Zanfina Ademi, Stella Talic","doi":"10.1007/s40266-026-01330-9","DOIUrl":"https://doi.org/10.1007/s40266-026-01330-9","url":null,"abstract":"","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Planned Antihypertensive Deprescribing in Long-Term Care Residents: A Systematic Review of Randomized Evidence.","authors":"Guangxiang Jiang, Guang Yang, Yixing Liu, Dongran Han","doi":"10.1007/s40266-026-01342-5","DOIUrl":"https://doi.org/10.1007/s40266-026-01342-5","url":null,"abstract":"<p><strong>Background: </strong>Evidence supporting antihypertensive treatment in older adults is derived largely from populations that differ from long-term care residents, in whom frailty, dementia, multimorbidity, polypharmacy, and competing clinical priorities may alter the balance between preventive benefit and treatment burden.</p><p><strong>Objectives: </strong>The aim was to synthesize randomized evidence on planned antihypertensive deprescribing in institutional long-term care and determine whether clinically and methodologically comparable effects support a common treatment-effect estimate.</p><p><strong>Methods: </strong>Randomized or cluster-randomized studies of planned antihypertensive deprescribing in long-term care were systematically reviewed. MEDLINE/PubMed, Embase, CENTRAL, CINAHL Complete, Web of Science Core Collection, trial registries, and PROSPERO were searched from inception and updated to 20 August 2026. Meta-analysis was reserved for outcomes with at least two clinically and methodologically compatible estimates of a common, interpretable effect; otherwise, structured study-level synthesis was used. Result-specific risk of bias was assessed with the revised Cochrane risk-of-bias tool (RoB 2), and certainty with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool.</p><p><strong>Results: </strong>Three randomized long-term care studies involving 1548 residents were included. Their populations, deprescribing strategies, monitoring, restart criteria, and follow-up differed substantially, and no outcome was considered sufficiently clinically and methodologically comparable for meta-analysis. RETREAT-FRAIL reported an adjusted hazard ratio (HR) for all-cause mortality of 1.02 (95% confidence interval 0.86-1.21) over a median potential follow-up of 38.4 months, whereas DANTON reported an HR of 1.65 (0.95-2.85) to 32 weeks; Gulla/COSMOS had no cluster-adjusted comparative mortality estimate. At 16 weeks in DANTON, deprescribing increased systolic blood pressure by 11.0 mmHg (5.6-16.4), increased diastolic blood pressure by 4.6 mmHg (1.1-8.1), and reduced the number of antihypertensive drugs by 1.2 (1.0-1.4). Evidence for hospitalization, falls, cardiovascular events, cognition, function, and quality of life remained sparse, outcome-specific, or at risk of bias.</p><p><strong>Conclusions: </strong>Randomized evidence for antihypertensive deprescribing in long-term care remains sparse and clinically heterogeneous. Within individual trials, supervised deprescribing reduced antihypertensive exposure and raised blood pressure, but the magnitude and clinical consequences varied by strategy and follow-up. Current evidence does not establish a common effect on mortality, hospitalization, or other resident-important outcomes, making trial-specific estimates and deprescribing protocols more informative than a single pooled treatment effect.</p><p><strong>Prospero registration: </strong>CRD420261370802.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benzodiazepine Prescription and Use in the Older Adults in Catalonia, Spain from 2018 to 2022: A Drug Utilization Study.","authors":"Miliça Paut Kusturica, M Teresa Peñarrubia-María, Lucy Anne Parker, Sara Mucherino, Enrica Menditto, Valentina Orlando, Ignacio Aznar Lou","doi":"10.1007/s40266-026-01340-7","DOIUrl":"https://doi.org/10.1007/s40266-026-01340-7","url":null,"abstract":"<p><strong>Background and objective: </strong>Benzodiazepines (BZDs) remain among the most frequently prescribed psychotropic drugs in older adults, despite well-documented risks and guideline recommendations for short-term use. This study analyzed BZD prescribing trends among individuals aged ≥ 65 years in Catalonia, Spain, between 2018 and 2022.</p><p><strong>Methods: </strong>A retrospective drug utilization study was conducted using anonymized electronic health records from the SIDIAP (Information System for Research in Primary Care) database, covering approximately 80% of the Catalan population. All patients aged ≥ 65 years with at least one BZD prescription were included. Data were analyzed by sex, age group, onset of action, and duration of effect. Utilization was expressed in defined daily doses per 1000 inhabitants per day.</p><p><strong>Results: </strong>The study included 463,446 older adults (68.2% women; mean age 77.1 ± 8.0 years) with 1,731,408 BZD prescriptions. Rapid-onset BZDs accounted for 51.9% and intermediate-onset for 45.2% of prescriptions; slow-onset drugs were 2.95%. Intermediate-acting BZDs predominated by duration (47.6%), followed by short-acting BZDs (31.9%) and long-acting BZDs (20.4%). Women had higher use than men across all age groups (e.g., short-acting < 75 years: 233.6 vs 106.6 defined daily doses per 1000 inhabitants per day). Median treatment duration was longest for intermediate-acting BZDs (219 days, interquartile range 59-365) and intermediate-onset BZDs (221 days, interquartile range 59-365).</p><p><strong>Conclusions: </strong>Benzodiazepine prescribing among Catalan older adults remains high, dominated by rapid-onset and short-acting to intermediate-acting agents, with widespread long-term use. These findings highlight the need for structured medication reviews, deprescribing programs, and prescriber education to reduce inappropriate BZD exposure in this population.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Use in Older Adults with Cancer Pain Admitted to an Acute Palliative Care Unit: Does Age Matter? A Secondary Analysis.","authors":"Sebastiano Mercadante, Yasmine Grassi, Sofia Settepani, Alessio Lo Cascio, Alessandra Casuccio","doi":"10.1007/s40266-026-01328-3","DOIUrl":"10.1007/s40266-026-01328-3","url":null,"abstract":"<p><strong>Background: </strong>Cancer pain in older adults presents unique management challenges because of age-related pharmacokinetic and pharmacodynamic changes. Data on age-stratified opioid prescribing within acute palliative care units remain scarce.</p><p><strong>Objective: </strong>We aimed to evaluate the influence of age on opioid dosing, drug selection, and breakthrough pain management in patients with advanced cancer admitted to an acute palliative care unit.</p><p><strong>Methods: </strong>We conducted a secondary analysis of a prospective observational study conducted over 5 months. Patients were stratified into three cohorts: adults (A, aged <65 years), young-old (O, aged 65-75 years), and old-old (OO, aged >75 years). Opioid doses, expressed as oral morphine equivalents (mg/24 h), drug choice, and route of administration were recorded at admission, at each opioid prescription change, and at discharge. Kruskal-Wallis tests with pairwise post hoc comparisons using Holm correction and Friedman tests were used for between- and within-group analyses, respectively.</p><p><strong>Results: </strong>One-hundred and thirteen patients were analyzed (A: n = 46, O: n = 43, OO: n = 24). No significant differences in oral morphine equivalents were observed at admission (p = 0.177). Significant between-group differences emerged from the first opioid prescription (p = 0.007), persisted at the second prescription (p = 0.026), and were most pronounced at discharge (p < 0.001). Pairwise post hoc comparisons consistently showed higher oral morphine equivalent doses in adults than in both geriatric age groups, whereas no significant differences were observed between the young-old and oldest-old groups. Methadone was used predominantly in adults. At the first breakthrough pain prescription, adults also received significantly higher rescue oral morphine equivalent doses than the two older groups (p < 0.05). Pain intensity significantly improved from admission to discharge in all three age groups, with no significant between-group differences observed either at admission or at discharge.</p><p><strong>Conclusions: </strong>Age was associated with clinically significant differences in opioid prescribing within the acute palliative care unit. Compared with patients aged ≥65 years, adults aged <65 years received higher opioid doses and more complex opioid regimens, whereas prescribing patterns were similar in the two geriatric age groups. Despite age-related differences in opioid prescribing, comparable pain control was achieved across all age groups (see Table 1 and Results), supporting individualized age-tailored opioid titration in specialist palliative care.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"909-919"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Adherence Trajectories of First-Line Nucleotide Analogues among US Older Adults with Chronic Hepatitis B.","authors":"Javeria Khalid, Prasun Kumar Jalal, Jieni Li, Hua Chen, Xi Lu, Rajender R Aparasu","doi":"10.1007/s40266-026-01332-7","DOIUrl":"10.1007/s40266-026-01332-7","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of first-line nucleot(s)side analogs (NAs) for managing chronic hepatitis B (CHB) depends heavily on treatment adherence; however, evidence on longitudinal adherence patterns is limited, especially in older adults.</p><p><strong>Objective: </strong>This study examined longitudinal adherence trajectories of NAs among older adults with CHB.</p><p><strong>Methods: </strong>This retrospective cohort study involved continuously enrolled Medicare beneficiaries aged ≥ 65 years with CHB from 2014-2019. Monthly adherence was evaluated using proportion of days covered for incident NAs users, specifically entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF). Longitudinal adherence patterns were analyzed using group-based trajectory modeling (GBTM) over a 12-month follow-up. The variation in adherence trajectories across first-line NAs was examined using a multinomial logistic regression model, adjusted for baseline covariates.</p><p><strong>Results: </strong>The study cohort comprised 3,317 older adults with CHB, with a mean age of 72.6 years, and 57.85% were men. The GBTM identified three long-term adherence patterns: consistently adherent (56.89%), gradual decline (24.78%), and rapid decline (18.33%). The consistently adherent patients varied across the individual NAs (ETV = 52.21%, TDF = 57.39%, and TAF = 71.06%). Multinomial logistic model found that patients on TAF had 0.41 times lower odds of being rapid decliners (95% confidence interval [CI]: 0.34-0.49) and 0.45 times lower odds of being gradual decliners (95%CI: 0.39-0.53), compared to ETV.</p><p><strong>Conclusions: </strong>Over half of older adults with CHB consistently adhered to NAs, with significant variation in adherence patterns across the individual NAs. Overall, TAF was less likely to be associated with declining adherence patterns than other NAs. Understanding these long-term adherence patterns can help in developing targeted interventions to improve CHB care in older adults.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"921-931"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous Iron Therapy in Very Old Adults with Heart Failure: A Frailty-Oriented Therapeutic Perspective.","authors":"Rémi Esser, Marc Harboun, Marine Larbaneix, Alejandro Mondragon, Marlène Esteban, Christine Farges, Vincenzo Palermo, Nicolas Pages, Sophie Nisse Durgeat, Olivier Maurou","doi":"10.1007/s40266-026-01339-0","DOIUrl":"10.1007/s40266-026-01339-0","url":null,"abstract":"<p><p>Iron deficiency is common in heart failure (HF) and particularly frequent in older adults, in whom it may contribute to fatigue, exercise intolerance, impaired quality of life and functional decline, even without overt anaemia. In HF, intravenous iron has shown consistent benefits on symptoms, functional capacity and health-related quality of life in selected populations, mainly with reduced ejection fraction, and some studies have suggested a reduction in recurrent HF hospitalisations. However, more recent large trials have shown less consistent effects on hard clinical outcomes and a mortality benefit remains unproven. Importantly, the evidence underpinning current recommendations is derived predominantly from younger and highly selected HF populations, creating a major evidence-to-practice gap for patients who are very old and multimorbid. Although some pivotal trials included meaningful numbers of chronologically older participants, frailty, cognitive impairment, functional dependency, multimorbidity severity and treatment burden remain poorly characterised. Diagnostic criteria used in HF are also more difficult to interpret in older adults because of chronic inflammation, renal dysfunction, malnutrition and other age-related comorbidities that influence ferritin and transferrin saturation. Preliminary evidence in HF with preserved ejection fraction suggests a possible functional benefit, but available data remain insufficient to establish effects on clinical events or applicability to frail older populations. In this structured, clinically oriented review, we examine the pathophysiology, diagnostic challenges and trial evidence for iron deficiency management in older adults with HF, with particular emphasis on the mismatch between available evidence and real-world data on patients who are older and multimorbid. We also propose an illustrative frailty-informed framework integrating conventional biomarker thresholds, expected symptomatic and functional benefit, adverse-effect risk, cognition, treatment burden and patient goals, without using frailty as an automatic exclusion criterion.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"897-908"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Effect of a Multifaceted Pharmacist-Led Intervention on Medication Appropriateness and Medication Burden in Patients Admitted to an Acute Geriatric Ward: Results from the ASPIRE Trial.","authors":"Laura Hellemans, Lotte Blocquiaux, Julie Hias, Karolien Walgraeve, Astrid Liesenborghs, Astrid Lammens, Mieke Deschodt, Jos Tournoy, Lorenz Van der Linden","doi":"10.1007/s40266-026-01327-4","DOIUrl":"10.1007/s40266-026-01327-4","url":null,"abstract":"","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"957-959"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Urinary Retention in Older Women.","authors":"Rachna Sridhar, Joanna Marantidis, Anne P Cameron","doi":"10.1007/s40266-026-01323-8","DOIUrl":"10.1007/s40266-026-01323-8","url":null,"abstract":"<p><p>Urinary retention in older women is a clinically significant and often underdiagnosed condition with complex and multifactorial etiology. Age-related changes in bladder contractile function and bladder sensation, combined with common comorbidities such as neurologic disease, diabetic bladder dysfunction, and pelvic organ prolapse, substantially increase the risk of retention in this population. Medications commonly prescribed to older adults, including anticholinergics and antidepressants, are an often overlooked cause of urinary retention. Evaluation includes a thorough history, physical exam, medication reconciliation, and post-void residual volume, especially because symptoms of retention that are common in men are often non-specific in women. Management should be risk stratified, with acute retention requiring prompt bladder drainage and chronic urinary retention requiring assessment of symptom burden and risk of upper tract deterioration. Pharmacologic treatment options, such as alpha-blockers, have limited evidence in women and broader therapeutic options remain poorly studied in older female populations. Sacral neuromodulation can be effective for non-obstructive urinary retention in older women. This review highlights the critical need for sex-specific and age-specific trials to guide evidence-based patient-centered management of urinary retention in older women.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"885-895"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating Awareness of preScribing Cascades and Managing Adverse Drug Effects (CASC-ADE) Tool: Appraisal by Future End Users.","authors":"Kjell van der Walle, Petra Denig, Toone Boerman, Fabiënne J H Magdelijns, Johannes T H Nielen, Fatma Karapinar-Çarkit","doi":"10.1007/s40266-026-01334-5","DOIUrl":"10.1007/s40266-026-01334-5","url":null,"abstract":"<p><strong>Background: </strong>Despite increasing attention for prescribing cascades, healthcare providers (HCP) need tools for taking action. We developed a tool, comprising fact sheets that summarise background information and provide guidance for recognising, managing, and preventing specific prescribing cascades. The aim of this study was to explore end users' appraisal of the initial version of this 'Creating Awareness of prescribing Cascades and managing Adverse Drug Effects' (CASC-ADE) tool.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using an online questionnaire including 15 items (13 scored on 7-point Likert scales, 2 on a 7-point bipolar scale, with a score of 4 being adequate), covering four domains: purpose, rigour, usability, and usefulness. The questionnaire, alongside at least one fact sheet, was sent to a convenience sample of HCPs, medical and pharmacy students. Suggestions for improvement could be made by respondents. Descriptive statistics were evaluated separately for HCPs and students.</p><p><strong>Results: </strong>The study included 17 HCPs (9 pharmacists, 8 clinicians) and 12 students (6 pharmacy, 6 medical). All items received positive median scores: Likert scale items between 5 and 7 for HCPs and 5 and 6 for students, and bipolar scale items 4 for HCPs and 4-4.5 for students. Highest scores were seen for purpose, usability, and usefulness for recognising prescribing cascades (median 6-7). Usefulness for managing and preventing prescribing cascades received slightly lower scores (median 5-6). Fifteen HCPs and nine students were positive about using the tool in practice but some mentioned this would depend on its practical implementation. A few respondents suggested including more specific guidance for taking action.</p><p><strong>Conclusions: </strong>The initial CASC-ADE tool was positively appraised across the assessed domains by the HCPs and students. Further research is needed to assess whether its use will improve recognition, management and prevention of prescribing cascades.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"933-943"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Proton Pump Inhibitor Therapy Is Common Among Older Adults: An 8-Year Finnish Nationwide Register Study.","authors":"Leeni Minkkinen, Heini Kari, Fredriikka Nurminen, Juho Leppänen, Hanna Koskinen","doi":"10.1007/s40266-026-01335-4","DOIUrl":"10.1007/s40266-026-01335-4","url":null,"abstract":"<p><strong>Background: </strong>Proton pump inhibitors (PPIs) are widely prescribed for acid-related gastrointestinal conditions, yet concerns persist regarding their long-term use, particularly among older adults, due to potential adverse effects and frequent lack of clear indications. This study examined nationwide trends and patterns of PPI use in Finland, with a specific focus on long-term use among older adults.</p><p><strong>Methods: </strong>We used nationwide prescription data from the Finnish Prescription Centre (2017-2024) to examine PPI use in older adults (aged ≥ 65 years), with working-age adults (aged 18-64 years) as a comparison group. Patterns of PPI use, initiation, long-term use (≥ 3 dispensations/year), polypharmacy, and co-medication with antithrombotic agents, corticosteroids, and nonsteroidal antiinflammatory drugs were analyzed using descriptive statistics.</p><p><strong>Results: </strong>Between 2017 and 2024, the number of PPI users increased by 12% and dispensations by 37%, with a steeper increase among older than working-age adults. In 2024, nearly half of all PPI users were aged ≥ 65 years, of whom 56.3% were classified as long-term users, compared with 34.1% among working-age adults. Long-term PPI use increased in both age groups, with an approximately 2.5-fold higher relative annual increase among older adults than among working-age adults. Long-term PPI use was more common among female than male individuals across nearly all age groups. Among older adults, PPI use was frequently accompanied by polypharmacy: 47% used more than ten other prescription medicines, and 39% received anticoagulants.</p><p><strong>Conclusions: </strong>Long-term PPI use is highly prevalent among older adults in Finland. These findings highlight the need for regular medication reviews and targeted deprescribing efforts to improve pharmacotherapy quality and safety in aging populations.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"945-955"},"PeriodicalIF":4.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}